Engagement Specialists Address Unmet Needs

Because of their unique ability to engage, Albuquerque Health Care for the Homeless Engagement Specialists are an effective response to successfully addressing unmet needs of people who are experiencing homelessness. Engagement is the process through which clients become active and involved in their treatment. Two Engagement Specialists have increased the proportion of people who access services at AHCH and have decreased campus incidents.

Follow us along as we spend a day with them out in the field

At the corner of Central Avenue and Tramway, on a grassy patch behind a gas station, a Navajo woman rests on a blanket in the shade of a tree. Her head is perched upon a dusty backpack which holds all her possessions. Her shoes and socks are also within her reach. Fall is due to arrive in a few days. Tender leaves are still abundant on branches and the air is crisp.

AHCH Engagement Specialist Kristy approaches her. Being a trauma-trained, outreach specialist, she is aware of how the pathology of trauma works and operates; therefore, she engages like she is talking with someone for whom she wishes to start a relationship with or get to know. “Hi doll. How are you today?” asks Kristy.
“Hey girl. I’m ok. Just chilling you know,” says the woman. She adjusts her sunglasses, pulls back her hair into a ponytail, and sits up. She invites Kristy to sit with her on the blanket, and the two women engage in conversation.

Kristy listens as the woman tells her about her situation and begins assessing her various needs, including any unmet medical concerns. “It’s hard out here girl. I’m trying to get it together but I fall short so I got to do what I gotta do,” she says. She discloses to Kristy that she is resting after being up all night working.

Some people experiencing homelessness turn to sex work as means of staying alive or obtaining the necessities of life. Known as “survival sex” this includes the exchange of sex for money, as well as food, clothing, or shelter. For some people, sex work stems from a background of poverty, substance misuse, or physical or emotional abuse. With limited gender-specific services in Albuquerque, and high levels of sexual and domestic violence risks associated with sex work, AHCH identified a need for more outreaches that are driven by women’s experiences.

“I know sweetie,” says Kristy. People’s general perceptions of sex work has been shaped by harmful stereotypes. In Kristy’s experience, she believes people forget that every woman or girl, no matter what she has been through, has an inherent strength and sacred worth.

Street outreach has long been a best practice-based method for locating people who are experiencing homelessness to connect them to life changing health care, social and housing services.
Kristy has been an Engagement Specialist for approximately seven months. She said working at AHCH has been an enriching life experience. She said she has seen an increase of support for women and sex workers accessing services in the medical and harm reduction program. She said it’s rewarding to connect people to care that navigates them out of homelessness.

The foundation for any success in addressing the social determinants of health and health issues, for people experiencing homelessness to end their homelessness is through the ability to engage. For AHCH, engagement refers to the process through which clients become active and involved in their treatment.

According to AHCH Harm Reduction Outreach Program Coordinator Kevin Santry, Engagement Specialists, when not on outreach, provide a consistent staff presence on the AHCH campus; maintain a safe and welcoming environment for all persons entering AHCH’s health campus for participation in the programs or services; build rapport, engage and de-escalate situations, and act as a liaison to First Responders in the event of an emergency. “Kristy and Tracy are valuable to the agency, to the clients, and to the staff. They are frequently or often the first point of contact. They help guide and navigate people to where they need to be,” said Kevin.

Further, Kevin emphasizes that providing health care begins from an understanding of the experience of homelessness by developing cultural competency and by hiring a diverse staff who have either experienced homelessness, reflect the target population, and/or have a track record working with people experiencing homelessness. This is an important first step in engaging with clients.

Back at the AHCH campus in downtown Albuquerque, Engagement Specialist Tracy is approached by a man who is carrying a large backpack and a cup of coffee, courtesy of the self-serve coffee in the AHCH Resource Center. It rained overnight so he has on a heavy coat and boots. His jeans are frayed at the edges, carrying some mud particles and blades of grass. He sets his backpack down and strikes up a conversation.

“Good morning sir. How you doing?” asks Tracy. His presence in the AHCH courtyard increases the proportion of clients who engage in services and re-engage, rely on his ability to welcome them and let them know they can be here and increase safety on campus.

“I’ve been better,” says the exhausted man. He sits on the concrete bench, wipes the sweat from the forehead with a handkerchief and shakes the mud off his jeans. He blows the steam away from his coffee and takes a sip. And another sip.

“How can I help you today?” asks Tracy who works within a trauma informed care and harm reduction philosophy. Tracy possesses the ability to bring in individuals to services with positive engagement.

“Could I get a bus pass, man? I need to get across town today,” he asks. Tracy hands him a bus pass. He slides it into his shirt pocket, snaps the button closed, and pats it down, making sure it’s still there. For him, having a bus pass increases his chances of taking care of his daily needs. People experiencing homelessness are more likely to become ill and are more likely to die twenty years younger than the general population.

Factors affecting access to services for people experiencing homelessness include: exposure to the elements, poor nutrition, violence in the streets, and the stress of being homeless all of which contribute to poor health and decrease the chances of staying healthy and moving out of homelessness. Illnesses last longer, and may result in greater complications, both because of environmental stressors and barriers to receiving appropriate care.

On a typical day, Tracy arrives on the AHCH campus at 6 a.m. He greets people who have formed a line into the AHCH Resource Center. “It takes me about thirty minutes to say hi to everyone because they have stories and want to tell me everything,” says Tracy. The Resource Center provides a warm, open space for people to get coffee, rest, speak to a Client Advocate, take a shower, get an identification card, or complete a housing assessment to obtain housing.

The New Mexico Coalition to End Homelessnessmanages the NM Coordinated Assessment System, which is a system to help connect people experiencing homelessness to supportive housing programs. AHCH participates in the Coordinated Entry System which is an assessment tool to determine what types of housing and support would best help a homeless individual or family. The Coalition’s Coordinated Entry System staff use the Homeless Management Information System to identify who is in the most need of supportive housing, based on the results of the housing assessment tool, and which supportive housing programs have openings. The Coordinated Entry System has expanded to include everyone experiencing homelessness, including families with children and, unaccompanied youth.

Recently, Tracy was commended by the NMCEH for his effort in collecting vital information that others are unable to, to follow-up with people who have completed housing assessments, which lead to some people getting housed. AHCH Engagement Specialists have completed nearly 50 housing assessments in the last three months.

Tracy further explains why he enjoys working at AHCH, “I was destined to help. I was destined to be of service. Human Services is my path. I hear people tell me every day, ‘Thank you. You pointed me in the right direction.’” He summarizes, “We (Engagement Specialists) are health care.” Before working at AHCH, Tracy worked at a shelter for people who were experiencing homelessness in New York City for six years.

You too can make a difference and impact in saving a life today. Your giving provides healthcare, help, and dignity to people experiencing homelessness here in Albuquerque.

AHCH is a proud member of Community Health Charities, formally known as National Voluntary Health Agencies and Combined Health Appeal of America. Community Health Charities (CHC) provides AHCH with direct services to help us enhance our operations, programs, and community services through access to workplace giving, as well as opportunities to create community level relationship with corporations and their donors. The mission of CHC is to unite caring donors in the workplace with the nation's most trusted health charities. To participate in the program, please submit the form with the CFC code: 35581.

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This health center is a Health Center Program grantee under 42 U.S.C. 254b, and a deemed Public Health Service employee under 42 U.S.C. 233(g)-(n).

This health center receives HHS funding and has Federal Public Health Service (PHS) deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals.